Disorders of the vestibular system present important clinical problems. Dizziness, a term which can embrace imbalance, vertigo, and light-headedness, affects more than 20% of the working age population, bedside tests suggest vestibular disorders in 35% of those over 40, and the prevalence is greater than 60% in the elderly. Using a more strict definition of vertigo, a prevalence of 7.4% was suggested, 80% of who seek medical consultation. Disorders of balance can be classified into one of two major categories: central vestibular disorders (i.e., disorders of the brain and central nervous system) and peripheral vestibular disorders (disease of the inner ear and eighth cranial nerve).
Migraine is one of the most common central disorders associated with vertigo, producing dizziness symptoms in 3.2% of the population. Of those who consult a physician for these symptoms, only 20% are correctly diagnosed, and fewer are appropriately treated. Vestibular disorders are likely poorly identified due to physician training and limitations in current vestibular tests. There are currently several names used in the literature to describe vertigo due to migraine, including migrainous vertigo, migraine associated dizziness, and chronic subjective dizziness. This document refers to all of these as migraine associated vertigo (MAV). Despite being very common, MAV is difficult to diagnose, due to controversy in what diagnostic criteria should be used and current lack of any diagnostic test.